Childhood Immune Thrombocytopenic Purpura

Q:My nephew aged 5 years has been diagnosed with ITP. His platelet count had gone down to 2000 when admitted to the hospital. He was given IVIG (2 doses 1gm/kg) and also platelet infusion. I would like to know if this is the correct or treatment or there is some other course of drugs to be given. Is this dose sufficient or will he have to take it on a recurring basis?

A:Childhood ITP is characteristically acute and often resolves spontaneously in few months and remission is generally permanent. Opinions about the need for treatment and the choice of drugs to be given remain divided amongst haematologists. However, most paediatricians and haematologists would give treatment with IVIg and/or glucocortcoids at such low platelet values. Followup is recommended for some interval in most cases. Need for another course or alternative therapy depends upon individual getting another episode or the patient having chronic ITP or some other cause of thrombocytopenia.